Health affairs
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Since 1987, public and private investment in substance abuse (SA) treatment has not kept pace with other health spending. SA treatment spending in the United States grew from $9.3 billion in 1986 to $20.7 billion in 2003. ⋯ S. health care spending grew by 8.0 percent. As a result of the slower growth of SA spending compared to that for all health care, SA spending fell as a share of all health spending from 2.1 percent in 1986 to 1.3 percent in 2003.
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Per capita health spending across countries ranges by more than 100 to 1, leading many people to ask, "What should a country spend on health care?" This paper discusses four approaches to this question and demonstrates how each approach, in effect, answers a slightly different question, all of which are important to public policy decisions regarding health care spending. The paper also addresses a commonly cited World Health Organization statement that countries should spend 5 percent of national income on health care services.
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We compare strategies to manage surgical waiting times in Australia, Canada, England, New Zealand, and Wales to give policy insights into those that are most effective. Most of these countries have allocated dedicated funding and set explicit waiting time targets. Of the five countries, England has achieved the most sustained improvement, linked to major funding boosts, ambitious waiting-time targets, and a rigorous performance management system. While supply-side strategies are used in all five countries, New Zealand and parts of Canada have also invested in demand-side strategies through the use of clinical criteria to prioritize access to surgery.